CEREBRAL PERFUSION CORRELATES OF NEGATIVE SYMPTOMATOLOGY AND PARKINSONISM IN A SAMPLE OF TREATMENT-REFRACTORY SCHIZOPHRENICS - AN EXPLORATORY TC-99M-HMPAO SPET STUDY

There is a well recognized clinical overlap between primary and second ary neuroleptic negative symptoms in schizophrenia, but their cerebral substrates are probably different. The study of these substrates coul d contribute to a better understanding and management of these syndrom es, In the present work, the cerebral perfusion correlates, as an indi rect measure of the underlying neuronal function, of negative symptoms and parkinsonism were studied with single-photon emission tomography in a group of treatment-refractory paranoid schizophrenic patients, Pe rfusion ratios with respect to the homolateral cerebellum were compare d with a normal database, Correlation coefficients were calculated bet ween perfusion ratios, negative symptoms and parkinsonism scores on ex ploratory grounds. As a group, the patients showed a bilateral, but pr edominantly left-sided, hypofrontality and hypotemporality, as well as an increased perfusion in right basal ganglia. Negative symptoms scor es negatively correlated with prefrontal perfusion, while parkinsonism positively correlated with the activity of primary motor and sensory cortex. These findings support the existence of different cerebral sub strates for primary and secondary negative symptoms in schizophrenia. (C) 1997 Elsevier Science B.V.